As Americans debate whether the Patient Protection and Affordable Care Act (ACA) and its promise of guaranteed healthcare coverage should be overturned, a surprising number of less affluent nations are moving to provide medical insurance to all citizens. Many political leaders globally have concluded that creating a system of universal healthcare is essential to remaining competitive and supporting economic growth.
After years of underfunding healthcare, China is completing a three-year, $124 billion initiative that will cover more than 90 percent of its population. Mexico, which 10 years ago covered less than 50 percent of its population, just completed an eight-year drive for universal coverage that has noticeably expanded access to lifesaving treatments for diseases. In Thailand, where the GDP per person is 20 percent of America’s, just one percent of the population doesn’t have health insurance. Rwanda and Ghana — among the world’s poorest nations — are creating networks of insurance plans to cover their citizens.
“This is truly a global movement,” said Dr. Julio Frenk, a former health minister in Mexico and dean of the Harvard School of Public Health. “As countries advance, they are realizing that creating universal health-care systems is a necessity for long-term economic development.” Many countries are still struggling to improve the quality of their medical care. And making health care affordable remains a challenge for most countries, as it does for the U.S., where about 15 percent of the population lacks coverage.
Today, the United States is the only one of the world’s richest nations that does not provide healthcare coverage for all citizens. The Supreme Court is expected to hand down a ruling on a legal challenge to the ACA in June.
Some countries established public systems similar to those in Great Britain and Canada. Others rely on a mix of government and commercial insurance, similarly to the ACA. The Thai system, set up a decade ago, has survived years of political upheaval and a military coup. “No party dares touch it,” said Dr. Suit Wibulpolprasert, a senior adviser to the Ministry of Public Health.
“We are really an outlier,” said David de Ferranti, a former World Bank vice president who heads the Results for Development Institute, an international non-profit organization based in Washington. That stands in sharp contrast to the United States’ leadership in education, he said. Long before most European nations, the United States assured access to public schooling.
“People are demanding responses from their governments,” said Cristian Baeza, the World Bank’s director for health, nutrition and population. In countries such as India, political leaders know that one of the surest ways to get votes is to promise better access to healthcare.